Shahrekord University of Medical Sciences, Shahrekord, Iran.
Shiraz University of Medical Sciences, Shiraz, Iran.
Folia Med (Plovdiv). 2021 Feb 28;63(1):15-23. doi: 10.3897/folmed.63.e53506.
Enterococci have been considered as one of the most common causes of nosocomial infections. The spread of antibiotic resistance has posed a serious challenge to treating the enterococcal infections. High-level aminoglycosides resistance leads to failure in the synergistic combination therapy. This study aimed to estimate the prevalence of high-level gentamicin resistance (HLGR) among clinical isolates of enterococci in Iran.Systematic literature search was conducted in the Web of Science, PubMed, Scopus and Google Scholar electronic databases from ar-ticles which were published from April 2000 to September 2018. Literature search yielded 918 studies. Eligible studies were selected ac-cording to the defined inclusion and exclusion criteria. Statistical heterogeneity was estimated by Q statistic and the I2 index. The Begg's rank correlation test and Egger's weighted regression tests were used to evaluate possible publication bias.Nineteen studies were included in this review. According to the meta-analysis results, the prevalence of HLGR among Enterococcus spp. was 49.4% (95% CI: 42.2%-56.6%). It was estimated 44.3% (95% CI: 38.1%-50.8%) and 66.3% (95% CI: 51.4%-78.6%) for E. faecalis and E. faecium, respectively.Since notable rate of HLGR in enterococci was seen in this analysis, improving the implementation of all aspects of the infection control programmes is required. Accurate and regular monitoring of infection control procedures are necessary for reducing the dissemination of such infections.
肠球菌已被认为是医院感染的最常见原因之一。抗生素耐药性的传播对肠球菌感染的治疗构成了严重挑战。高水平氨基糖苷类耐药导致协同联合治疗失败。本研究旨在估计伊朗临床肠球菌分离株高水平庆大霉素耐药（HLGR）的流行率。系统检索了 Web of Science、PubMed、Scopus 和 Google Scholar 电子数据库中 2000 年 4 月至 2018 年 9 月发表的文章。文献检索得到 918 项研究。根据定义的纳入和排除标准选择合格的研究。通过 Q 统计量和 I2 指数估计统计学异质性。贝氏等级相关检验和埃格氏加权回归检验用于评估可能存在的发表偏倚。本综述纳入了 19 项研究。根据荟萃分析结果，肠球菌属 HLGR 的流行率为 49.4%（95%CI：42.2%-56.6%）。粪肠球菌和屎肠球菌的分别估计为 44.3%（95%CI：38.1%-50.8%）和 66.3%（95%CI：51.4%-78.6%）。由于本分析中肠球菌 HLGR 的发生率较高，因此需要改进感染控制计划的各个方面的实施。需要准确和定期监测感染控制程序，以减少此类感染的传播。
